CHAPTER FOURTY-SEVEN DRUG THERAPY Flashcards
how can drugs pass the blood brain barrier
be lipid soluble
what is myasthenia gravis
weakness or rapid fatigue of muscles
-autoimmune neuromuscular disorder
-shown in face expression, swallowing, weakness of eye muscles
treatment for myasthenia gravis
cholinergic drugs/acetylcholinesterase inhibitors
what kind of drug is neostigmine
acetylcholinesterase inhibitor
-reverses action of nondepolarizing neuromuscular blocking agents
-administered intravenously
-treats myasthenia gravis
adverse effects of acetylcholinesterase inhibitors and treatments for them
cardiovascular and respiratory issues
-nervous system effects (convulsions, dizziness)
- cant be used if hypersensitive, have lung disease, heart disease or benign prostatic hypertrophy
-can give atropine to decreases effects and give with food if given orally
-can give pyridostigmine to increase Ach
therapeutic effects of acetylcholinesterase inhibitors
-increase muscle strength
-decrease difficulty swallowing, speaking, and ptosis
what does cholinergic crisis look like
extreme weakness
SLUDGE
-salivation, lacrimation, urine incontinence, diarrhea, GI upset, Emesis
Atropine is the antidote, acts on heart, smooth muscle and glands
other treatments: decontamination, activated charcoal, hydration
characteristics of overstimulation of PNS
BAGPUDDLES
-bronchoconstriction+
-apnea
-gray vision
-pupil constriction
-increased urination
-diaphoresis
-deification
-lachrymation
-emesis
-seizures
what is Alzheimer’s disease
memory loss and loss of intellectual abilities
-most common form of dementia
-deficiency in cholinergic function
-treatment: cholinesterase inhibitors
what kind of drug is donepezil
cholinesterase inhibitor
- inhibits Ache
-oral administration, peak is 3-4 hours
-normally used with memantine, discontinue if no improvement
causes of urinary retention
spastic: contractions with low volume
-renal or spinal damage
-flaccid: large fluid volume but decreased pressure
-Diabetes, enlarged prostate, pregnancy, parkinsons, ms, surgery
treatment: cholinergic agonist
what kind of drug is memantine
NMDA N-methyl-aspartate receptor antagonist
-absorbed well orally
-blocks the glutamate receptor
contraindications: hypersensitivity and renal failure
-normally used with donepezil, discontinue if no improvement
what kind of drug is bethanechol chloride
-well absorbed in GI, not sure of metabolism/excretion, does cross placenta
-increases muscle tone in GI and Urinary system
-used for bladder retention